Application for Reception Order under s. 20 of the Mental Health Act 1987

To
The Sub-divisional Judicial Magistrate
Sir
I beg to submit that my wife Smt.................................... aged.......... and mother of two children, has become a mentally ill person for the last several months. She has been treated by local physicians but there appears to be no improvement in her condition. It is necessary for the patient to be admitted in a psychiatric hospital or nursing home for observation and proper treatment. Medical certificates from two physicians one, of whom is a medical practitioner in the service of the Government, testifying to the mental condition of the said patient Smt...................................are enclosed.
It may be noted that no previous application had been made either for enquiry into the condition of the patient or for her admission to any hospital.
The statements made above are true to my knowledge.

Yours faithfully